Sexual Health Roundup: HPV Vaccine Doesn’t Lead to Promiscuity; Condom Use Low Among Women on the Pill

We’ve heard the argument many times about everything from birth-control pills and condoms to sex education: Giving kids information or access to protection is like giving them license to have sex and will make them promiscuous. Most recently this argument has been made about the HPV vaccine because—to ensure that the vaccine series is given before a young woman becomes sexually active—the CDC recommends that girls be vaccinated during their preteen years. Last week researchers at Kaiser Permanente were able to reassure parents that the vaccine is safe. This week they offer reassurance that it does not cause increased sexual activity.

Researchers followed 1,400 girls in Atlanta for three years after they’d received their shots. They did not ask the girls if they’d had sex but instead looked for markers in their medical records, such as pregnancy tests, STI diagnoses, or contraceptive counseling, that would indicate sexual activity. They found no differences between girls who got the HPV vaccine and girls who got other vaccines but not HPV. The study’s lead author explained:

“Overall, what we found through the whole follow-up study was among 1,400 girls only eight actual cases of either pregnancy or sexually transmitted infection.”

He went on to say that the rates were identical in the HPV vaccine and non-HPV-vaccine groups. And added:

“We feel this is reassuring. We can start to move beyond these concerns.”

This research followed girls only until they were ages 15 or 16, which is about the average age of sexual activity for young women in this country. Other research, including a report from the CDC, found no association between HPV vaccination and risky sexual behavior among young women ages 15 to 24, though that finding was based on self-report, not medical records.

Experimental Vaccine Might Help Women Already Infected With HPV

The HPV vaccines that are currently available—Gardasil and Cervarix—protect young women (and men) from initial infection with certain strains of human papillomavirus. Both Gardasil and Cervarix are approved for the prevention of infections with HPV strains 16 and 18, which are most likely to cause cervical cancer. Gardasil also prevents strains 6 and 11, which cause genital warts. These vaccines have no effect on women who are already infected.

Researchers are now working on an experimental vaccine for women who have already contracted HPV. It is designed to spur the body’s immune system to fight off pre-cancerous and cancerous changes to the cervix. The vaccine, known as VGX-3100, uses gene therapy to trigger the body’s T-cells (part of the immune system) to “seek out and destroy precancerous lesions.”

The study, published in the October 10 issue of the journal Science Translational Medicine, follows 18 patients who were given three doses of the vaccine along with a small electric pulse, called electroporation, which boosts the post-shot immune response. The study found that the vaccine seemed to “elicit the desired immune response against HP with minimal side effects.”

This study is a phase-one clinical trial; the second phase is already under way. If it continues to be successful, the vaccine could be available within four to six years.

A new study published in the Journal of Adolescent Health finds that young women who start using hormonal contraception for birth control often stop using condoms, leaving themselves open to sexually transmitted infections (STIs). More disturbing, however, is the finding that if these young women discontinued using hormonal contraception they tended not to resume their use of condoms, leaving them completely unprotected against both unintended pregnancy and STIs.

The year-long study followed 1,194 sexually active women ages 15 to 24, who visited Planned Parenthood clinics. They were not planning to get pregnant within the year and were starting hormonal contraceptives—birth-control pills, patches, injections, or vaginal rings. Researchers asked the women about their condom use. They also asked what their attitudes toward condoms were, as well as their perceptions of their partners’ attitudes toward condoms. At the beginning of the study, 36 percent of the women used condoms consistently but this dropped to 27 percent within three months. During the course of the year, some of the women stopped using their hormonal methods but more than half of those who did, did not resume using condoms.

The study also found that the most important predictor of condom use was not a woman’s own feeling toward condoms. Nor was it her perceived risk of contracting STIs. Rather, it was her perception of her partner’s attitudes toward condoms. The study found that women who said their partners thought condoms were “very important” or didn’t know how their partners felt were more likely to use condoms along with their hormonal method than women who said their partners thought condoms were “not at all important.”

Condoms provide important protection against STI’s, including HIV. Most health professionals agree that even young women on hormonal methods of contraception should continue using condoms to prevent STIs. This study confirms the fear of public-health experts that young women are not taking this advice. Worse, they don’t return to condoms (which are also a good method of birth control) if and when they stop using hormonal methods. This study confirms that we need to do more education when it comes to condom use. And educating male partners might be a good place to start.